Kathryn H. Thompson, Ph.D.
April 11, 2001
Prenatal Nutrition and Lactation
To produce a healthy, normal weight infant while minimizing the short and
long term health risks to the mother
To determine the appropriate weight gain during pregnancy for the normal
weight underweight and overweight pregnant woman
To recognize the additional energy, vitamin and mineral requirements during
pregnancy and lactation
To recommend dietary modifications to help alleviate nausea, heartburn and
constipation during pregnancy
To develop skills to help promote and maintain breast-feeding
I. Questions with nutritional implications for the obstetric history
and physical exam
A. Present illness
1. General: recent weight change, poor weight gain, edema, dehydration
2. G.I. complaints: Diarrhea, nausea, vomiting, heartburn, constipation
B. Medical History
1. Prenatal vitamins, nutritional supplements, herbs, remedies?
2. Iron supplements/
3. Food allergies
4. Non-food cravings
5. Obstetric history
C. Social History
2. Special Diet?
3. How many meals and snacks daily?
4. Avoid any specific foods?
5. Milk: how much, type?
6. Lactose intolerance
D. Family History
1. Familial occurrence of dx
2. History of children with fetal anomalies
E. Review of symptoms
1. General: Fatigue, weight change
2. Month: teeth, gums, lips, tongue
3. GI/abdomen: Appetite, food intolerance, nausea, constipation, diarrhea
F. Physical Exam
1. Anthropometric data
b Current weight
c Prepregnancy weight
d Prepregnancy BMI
e Weight gain during pregnancy so far
G. Laboratory Evaluation
II. Maternal weight gain
1. BMI < 19.8
2. Total weight gain 28 - 40 lbs.
3. 5 lbs./ 4 weeks
1. BMI = 19.8 - 26
2. Total weight gain 25 - 35 lbs.
3. 4 lbs./ 4 weeks
1. BMI = 26.1 -29
2. Total weight gain 15 - 25 lbs.
3. 2.6 lbs./ 4 weeks
III. Nutritional requirements
A. Energy: + 300 kcal in 2nd and 3rd trimester
B. Protein: RDA = 60 g
IV. Nutritional Problems
A. Nausea and vomiting